Chronic pain increases fall risk in older persons

Chronic pain is known to be a cause of disability in older patients. It also is an overlooked and potentially important risk factor for falls and fall-related injuries in this age-group.

In the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston Study, Leveille and colleagues explored risk factors for falls in a population-based group of 749 persons 70 years or older. Study participants recorded their falls over 18 months. They were evaluated for cognitive/health/medication status and for chronic musculoskeletal pain. Pain was monitored each month with a single pain-rating question.

In all, 405 study participants (55%) reported falling at least once. Those with chronic pain fell more often than those without. Even after adjusting for comorbidities, chronic pain was independently linked with falls. This association also was independent of mobility function. For each joint pain site, the risk of falls increased particularly when several joints hurt. The risk also increased with pain severity. Similarly, pain that interfered with daily activities predisposed the patient to falling.

The authors suggested that a randomized controlled trial is needed to determine whether improved pain control could reduce the risk of falls in older patients with chronic pain.